Strategy
The Pennsylvania Bureau of Immunization (PA BOI) developed a new strategy for immunization quality improvement program (IQIP) visits by partnering with a health care system. Rather than making individual visits to Vaccines for Children (VFC) provider offices, the PA BOI collaborated with a large health system to offer an organization-wide IQIP. PA BOI worked with the health system’s leadership and quality improvement team to develop IQIP strategies that would be disseminated to 64 VFC provider offices.
Challenge
The Centers for Disease Control and Prevention (CDC) requires awardee VFC programs to initiate IQIP visits for at least 25% of jurisdiction-wide, VFC-enrolled providers each year. However, the PA BOI attempts to complete visits to 35% of enrolled providers per year. While the visits are a requirement for immunization programs, they cannot be required of VFC providers. Challenges faced by the PA BOI to complete IQIP visits include conflicts with scheduling initial visits and check-ins, difficulty selecting strategies, and lack of system leadership involvement, thus leading to less follow-through.
Solution
The PA BOI leveraged relationships with hospital system leadership, including the person responsible for quality improvement and the pediatric clinical office manager. Both individuals were familiar with the 64 pediatric offices and visited them frequently. The PA BOI collaborated with health system leadership to select IQIP strategies and develop action steps. The PA BOI conducted lunch and learn webinars for office managers and VFC coordinators to discuss the selected strategies and plans for implementation. The leadership team communicated expectations for individual office compliance with the strategy activities. Offices were surveyed to gather the office-specific baseline workflow and implementation data required for IQIP documentation.
Outcome
The PA BOI is still in the first year of implementing the health care system approach and continues to gather data, including pediatric cohort immunization rates and clinic satisfaction. In August 2025, a second health care system that has 55 clinics joined this approach. Anecdotal feedback thus far has been positive. Health care leadership has found the top-down approach as favorable due to maintaining consistency among clinic offices. IQIP strategies were in alignment with the health system’s quality improvement strategies, making it mutually beneficial for them and the PA BOI. In addition to leadership, this approach was also favorable with provider office staff due to increased flexibility and decreased burden on completing check-in meetings with the immunization program.
Supplemental Materials